Context: An increasing number of nonpalpable abnormalities requiring breast biopsy are being identified due to the widespread use of screening mammography. Large-core needle biopsy (LCNB) has become an alternative to surgical excision. Objective: To determine whether LCNB is a safe and accurate technique to evaluate nonpalpable abnormalities found on breast imaging studies. Design and Setting: Case series at an institutional referral center from August 1, 1991, to December 31, 1997. Patients: A total of 1643 women with 1 or more suspicious breast abnormalities received LCNBs (n = 1836 lesions). Intervention: The LCNB of the breast uses a 14- or 11-gauge needle with stereotactic localization or ultrasound guidance. Main Outcome Measure: Utility and potential limitations of LCNB compared with the criterion standard, surgical excision after wire localization. Results: Of the 1836 breast lesions sampled, 444 (24%) were found to be malignant. A total of 412 (22%) were found to be malignant on the initial LCNB and 202 repeat biopsies yielded 32 additional malignancies. Complications were infrequent: 1 patient experienced a superficial infection and 1 developed a pneumothorax after LCNB. Conclusion: Image-guided LCNB is a reliable diagnostic alternative to surgical excision of suspicious nonpalpable breast abnormalities.
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